近日,，刊登在Cochrane Reviews上的一篇文章中,，詢證醫(yī)學(xué)的研究者指出，HIV感染的高危人群可以通過服用抗逆轉(zhuǎn)錄病毒藥物來降低其獲得感染風(fēng)險(xiǎn),?？鼓孓D(zhuǎn)錄病毒的療法（ART）是專門針對疾病達(dá)到某一程度時(shí)候?qū)Ω腥菊咚M(jìn)行的療法，抗逆轉(zhuǎn)錄病毒藥物也被開始用于高危人群,，藥物的使用是為了起到暴露前預(yù)防（PrEP）的作用,，PrEP通常來說具有爭議性，不僅僅是因?yàn)槲锤腥镜娜巳簳?huì)產(chǎn)生對藥物的耐藥以及產(chǎn)生某些副作用比如腎臟毒性,、骨密度流失等,，而且是因?yàn)镻rEP提供的保護(hù)或許會(huì)鼓勵(lì)人群進(jìn)行高危行為，如性行為等,。
研究者分析了6組試驗(yàn)的數(shù)據(jù),，這6組試驗(yàn)中，研究者檢測了每日口服一定劑量的替諾福韋酯（TDF）（加或者不加恩曲他濱<FTC>）,，相比服用安慰劑時(shí)產(chǎn)生的效應(yīng),。試驗(yàn)中包括9849個(gè)參與者，來自4組獨(dú)立試驗(yàn)和8813個(gè)參與者的實(shí)驗(yàn)結(jié)果揭示了TDF加上FTC可以降低大約一半的HIV感染風(fēng)險(xiǎn),；來自兩組的試驗(yàn)和4027個(gè)參與者,，結(jié)果顯示，單獨(dú)服用TDF可以降低約2/3的HIV感染風(fēng)險(xiǎn),。
研究者表示,，抗逆轉(zhuǎn)錄病毒藥物的服用可以降低高危人群HIV感染的風(fēng)險(xiǎn)，試驗(yàn)結(jié)果顯示,，服用抗逆轉(zhuǎn)錄病毒藥物后,，參與者并沒有任何嚴(yán)重的副作用。最終研究者表示,，俄日來還需要深入的研究來證明是否PrEP真的有必要,，當(dāng)然目前來看這種方法是一種新的安全可靠的方法,。當(dāng)然了當(dāng)前還存在很多問題，比如我們?nèi)绾巫鰜泶_保ART的計(jì)劃等等,。（生物谷Bioon.com）
編譯自：Drugs Used to Treat HIV Also Reduce Risk of HIV Infection, Review Suggests
doi:10.1002/14651858.CD007189.pub32
PMC:
PMID:
Antiretroviral pre-exposure prophylaxis (PrEP) for preventing HIV in high-risk individuals
Charles I Okwundu1,*, Olalekan A Uthman1, Christy AN Okoromah2
Background More than 30 years into the global HIV/AIDS epidemic, infection rates remain alarmingly high, with over 2.7 million people becoming infected every year. There is a need for HIV prevention strategies that are more effective. Oral antiretroviral pre-exposure prophylaxis (PrEP) in high-risk individuals may be a reliable tool in preventing the transmission of HIV. Objectives To evaluate the effects of oral antiretroviral chemoprophylaxis in preventing HIV infection in HIV-uninfected high-risk individuals. Search methods We revised the search strategy from the previous version of the review and conducted an updated search of MEDLINE, the Cochrane Central Register of Controlled Trials and EMBASE in April 2012. We also searched the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov for ongoing trials. Selection criteria Randomised controlled trials that evaluated the effects of any antiretroviral agent or combination of antiretroviral agents in preventing HIV infection in high-risk individuals Data collection and analysis Data concerning outcomes, details of the interventions, and other study characteristics were extracted by two independent authors using a standardized data extraction form. Relative risk with a 95% confidence interval (CI) was used as the measure of effect. Main results We identified 12 randomised controlled trials that meet the criteria for the review. Six were ongoing trials, four had been completed and two had been terminated early. Six studies with a total of 9849 participants provided data for this review. The trials evaluated the following: daily oral tenofovir disoproxil fumarate (TDF) plus emtricitabine (FTC) versus placebo; TDF versus placebo and daily TDF-FTC versus intermittent TDF-FTC. One of the trials had three study arms: TDF, TDF-FTC and placebo arm. The studies were carried out amongst different risk groups, including HIV-uninfected men who have sex with men, serodiscordant couples and other high risk men and women. Overall results from the four trials that compared TDF-FTC versus placebo showed a reduction in the risk of acquiring HIV infection (RR 0.51; 95% CI 0.30 to 0.86; 8918 participants). Similarly, the overall results of the studies that compared TDF only versus placebo showed a significant reduction in the risk of acquiring HIV infection (RR 0.38; 95% CI 0.23 to 0.63, 4027 participants). There were no significant differences in the risk of adverse events across all the studies that reported on adverse events. Also, adherence and sexual behaviours were similar in both the intervention and control groups. Authors' conclusions Finding from this review suggests that pre-exposure prophylaxis with TDF alone or TDF-FTC reduces the risk of acquiring HIV in high-risk individuals including people in serodiscordant relationships, men who have sex with men and other high risk men and women.
